Barrett’s Esophagus: A Review of the Literature

Abstract

Barrett's esophagus (BE) is the premalignant lesion of esophageal adenocarcinoma (EAC) defined as specialized intestinal metaplasia of the tubular esophagus that results from chronic gastroesophageal reflux. Which patients are at risk of having BE and which are at further risk of developing EAC has yet to be fully established. Many aspects of the management of BE have changed considerably in the past 5 years alone. The aim of this review is to define the critical elements necessary to effectively manage individuals with BE. The general prevalence of BE is estimated at 1.6-3% and follows a demographic distribution similar to EAC. Both short-segment (<3 cm) and long-segment (≥3 cm) BE confer a significant risk for EAC that is increased by the development of dysplasia. The treatment for flat high-grade dysplasia is endoscopic radiofrequency ablation therapy. The benefits of ablation for non-dysplastic BE and BE with low-grade dysplasia have yet to be validated. By understanding the intricacies of the development, screening, surveillance, and treatment of BE, new insights will be gained into the prevention and early detection of EAC that may ultimately lead to a reduction in morbidity and mortality in this patient population.

Epidemiology of Barrett’s esophagus and esophageal adenocarcinoma in Spain. A unicentric study

“…However, Gilbert et al (28) described that BE could affect from 1.6% to 6.8% of the general population. In our series, BE and AEC incidence rates have increased from 2.25 and 1.25 per 100,000 inhabitants in 1996 to 6.5 and 4.75 per 100,000 in 2011, respectively.…”

Barrett’s Esophagus: Diagnosis and Management

“…While increasing length of BE is clearly associated with increased risk for malignant progression, there is a lack of consensus regarding what differentiates a short-segment Barrett's esophagus (SSBE) from an irregular squamocolumnar junction. The identifi cation of SSBE is clinically important because of a small increased risk of EAC even in people with SSBE [ 14 ]. In addition, there are no current guidelines regarding the number of biopsies required to establish an initial diagnosis of BE.…”

Complex General Surgical Oncology: A Case-Based Approach - Volume 1

“…Finally, it is worth noting that these practices apply only to 'pure' ADH. If additional, more aggressive disease is associated with ADH, treatment should be based on the more advanced diagnosis [8][9][10][11][12][13][14][15][16].…”

“…The correct answer is D. Primary lymphatic drainage of the breast is to the axilla [10]. Other extra-axillary nodal basins that may drain the breast include the internal mammary nodes, supraclavicular nodes, intra mammary nodes and interpectoral nodes.…”